A £500,000 review has revealed efforts to stem demand in Norfolk’s NHS has been “fire-fighting”, improvements were “starting from behind” and a lack of social care means patients stay in hospital eight days longer than necessary.

Norfolk and Waveney’s Sustainability and Transformation Partnership (STP) commissioned Boston Consulting Group to look into the area’s health service to see what needed to be done to keep it afloat.

And the report was presented to the Joint Strategic Commissioning Committee of the five NHS Clinical Commissioning Groups (CCGs) on Tuesday.

It found:

• If nothing was done an extra 500 hospital beds would be needed in the county, but even if suggested measures were put in place 140 more would still be required.

• Primary care was working at capacity, with the GP workforce shrinking.

• Community services could not meet demand, neither could social care and care homes.

• And there were serious financial worries with a £95m deficit expected for 2018/19 across all health organisations.

The report said: “Whilst much work has been done in recent years to address the capacity shortfalls this has largely been fire-fighting with little strategic thinking on how we can address the issues in the longer term across the whole system.”

Therefore a new demand and capacity team had been set up to try and tackle the issues.

The report did have some positives, including joint working meaning the organisations were “now moving in the right direction”, but there was still much work to be done.

And while a spokesman for the STP said many of the conclusions were already known, it was the “first time the health and care system in Norfolk and Waveney has undertaken such a significant and detailed piece of work”.

The report said the Queen Elizabeth Hospital (QEH), in King’s Lynn, had an “abnormally high temporary staffing burden”, while the Norfolk and Norwich University Hospital (NNUH) was “carrying a significant PFI cost contributing to a structural financial deficit”.

Patients at the QEH and the James Paget University Hospital (JPUH) in Gorleston were staying in hospital for an average of eight days after they were medically fit to go home, but there was not enough community or social care in place.

“All acutes are at or over capacity today,” the report said, with 170 medically fit patients in the three hospitals at any one time.

But the report writers said the issues could not simply be addressed by one provider, and organisations would have to work together.

It includes the launch of 20 new primary care networks. There is already one up and running in Norwich, the OneNorwich partnership, where GP practices work together.

But this was set to be expanded to include things such as mental health support, social workers, and voluntary groups, to provide more support.

The aim is for GP practices within each network to work in partnership with each other and other professionals in community and social care to deliver care that is more joined up and delivered closer to home. And it was thought A&E attendances could be reduced by 20pc with better primary care, as well as emergency admissions dropping by 3pc.

Plus £13m could be saved by ensuring patients who no longer need to be in hospital are moved on.

The independent chairman of the Norfolk and Waveney STP, Patricia Hewitt, said: “This comprehensive report shows that we have a real opportunity to transform the way the NHS works by strengthening GP practices, integrating community services, mental health and social care around the patient and reducing waste and duplication across the system.

“That way we can keep people safe and well at home, reduce emergency admissions and ensure our three acute hospitals focus on the patients who can only be treated in hospital. We can improve services for the people of Norfolk and Waveney and we can make the whole system sustainable.”

Norfolk and Waveney’s health and care organisations are discussing further what the most essential priorities are and will plan what steps need to be taken.